As has been said
I am Graham Morgan and I am the Advocacy Project Manager for Highland
Community Care Forum.
Care Forum exists to give voice to carers and users of community care
services. In my project we work with members of HUG, the Highland
Users Group. This is an advocacy group with 250 members, which represent
the views of people with a mental illness.
We also work with
People First, a network of 6 groups in the Highlands representing
people with learning disabilities. We are just starting some work
with the deaf community and also have a role in the development of
the different forms of advocacy across the Highlands. Perhaps, more
importantly from your perspective, I am also a user of mental health
In my early twenties
I was diagnosed as having a personality disorder and spent some time
in a world where I self harmed and eventually made a suicide attempt.
In my late twenties I became psychotic and was eventually diagnosed
as having schizophrenia. At this time I also self-harmed.
In the next half-hour
I intend to talk about self harm. What it was like and why I did it;
my suicide attempt and why it was different to self harm; and also
the different experience that I had of self harm when I was psychotic.
I hope also to
draw in some elements of the HUG report on "Suicide" that
we produced some years ago, and my experience of coping with the self-harm
and suicide of those around me in my role as a worker.
In HUG, a huge
part of our work is in raising awareness. We take the attitude that
when we talk about our own personal experiences we are talking about
just that - our experience. Some of the things that work for us may
work for others, some of the feelings that we have may be common to
others but we do not pretend to have the definitive experience or
answer to the, sometimes, horrific things we go through.
Anyway, to start
off with self harm:
I will start off
with a time around when I had just completed my first year at university.
I was a very shy, very awkward, confused and arrogant young person.
I had no idea who I was, what I believed in, how to react to other
people but at the same time I didn't really realise this. I tended
to see other people as the source of my problems.
In the year before
University I had spent part of my time in Israel on their northern
border when they had invaded Lebanon. Because I had had fleeting glimpses
of guns and rockets I liked to think that I had been moulded into
a man of wisdom before my time.
- and yet I found
it hard to walk across a café without thinking that everyone
was looking at me,
- I had no idea how to speak to people without being full of intensity
- I found women frightening and confusing
- I wondered around university in straggly untidy clothes
- I sat on the edge of radical groups and had arguments with them
- I sought out born again Christians to try to convert them to atheism!
- I railed against my family, my public school education, my university
course and tried to make sense of a world that I found confusing
For me there was
no sense and no meaning to anything, I was deeply unhappy. Unhappiness
was a pit in my stomach; it was an ache of unshed tears. In trying
to make sense of it all, to my alienation, my loneliness, my anxiety,
I put all my sadness down to my lack of a belief in a god. I cultivated
the philosophies of nihilism and existentialism without ever really
Life became increasingly
grey. The days became treacle to wade through and its sweetness tasted
of ashes. The learning I was meant to be doing at university became
an irrelevant burden that loomed over me. My smile was only ever a
half smile. I became sadder and sadder and more and more lonely and
miserable. Days stretched and merged into each other until they became
an uneventful blur and slowly but insistently the idea of suicide
grew and grew in my mind. It seemed the only logical, sensible option
to a pointless stay on our earth. It also seemed a romantic and bitter
blow to the world and people around me that I could not get on with.
I could see no way of gaining any purpose to my life.
There seemed to
be no future ahead that beckoned with any warmth. I was lost in myself
and in my vision of myself. Friends, family, work and pleasure did
not even scrape the surface of my conscience, they became irrelevant
in the world that I was finding I lived in.
I began to carry
knives around with me. I began to plan how to die. I told the people
who I knew that there was no point to anything that we did, and one
day I summoned up all my courage and misery and failed abysmally to
try to kill myself. I spent a weekend with a packet of razor blades
and a lot of alcohol. I intended to cut my wrists but I couldn't.
It was so frightening, so sickening, so final and so desperate.
As I held my razor
blade my skin felt like it was covered with ice, my heart raced, my
stomach felt empty and my hands trembled.
Over the weekend
I made a series of scratches across myself that became more and more
easy once I started. It felt like I was giving room to all my unhappiness.
Blood welled up and slid down and yet I felt both deeply angry and
ashamed that I couldn't kill myself and deeply shocked at what I had
That weekend signalled
a turn in my life. It signalled entrance into a world of people and
services that are defined by such acts, where such events are the
bread and butter of every day life. It also meant that I began to
take on the mantle of a new place in society, gaining a new vision
of myself which slowly began to reveal itself as someone on the edges,
someone with problems and labels.
The people in
my house were the first people that I told about this. They were very
helpful, very concerned, very upset and very clear that I needed to
see a doctor. I also knew that I should see a doctor but the threshold
of the surgery was so hard to cross. It was so frightening I didn't
know how to say what I was feeling, I didn't even know how to ask
for an appointment.
I sat on the wall
outside. I walked up and down, and I stood still. I told myself I
had to go in. I bullied myself to go in and eventually I crossed over
and the reception staff who had seen me hesitating for so long sent
me straight in to see the doctor without having to wait in the waiting
room. That was so good. I couldn't have faced the wait in the waiting
area and over the coming months found that place to be one of the
hardest to endure.
I couldn't speak
to the doctor. I had lost my words, my expression. I just pulled up
my sleeves and showed him my wrists and he took control and reassured
me and arranged for me to go to, what turned out to be, a student
hospital for a while.
The time out and
the access to understanding people, whether they were nurses or patients,
was great. It also gave significance to what was happening to me.
I found it difficult to believe that I was ill or deserved help, but
this showed that other people saw what I was going through and thought
that something needed done. I stayed there for a time and then left
to return to my house.
Nowadays we make
a great distinction between self-harm and suicide but in those days
I didn't see any difference. At home I continued to want to die. I
would wake up and wonder if I could kill myself that day, go in to
hear my lectures and then come home and cut myself and always I wouldn't
cut myself enough.
I would visit
the doctor weekly but I could hardly talk. To express myself was always
so hard. I tried writing down my thoughts but I didn't know what I
thought or believed. I tried to rationalise the way I was feeling
now with my past life. I dearly wanted to know why I was doing such
things - in fact many of my writings and pictures that I gave the
doctor were one long "why", but I didn't know why I was
asking the question. I was bewildered and lost in my own confusion.
At each visit
to the doctors I would sit in a jumble of whirring thoughts, so frightened
of those around me in the waiting room that I would often mishear
my name being called and barge into the previous patients session.
I was always hoping
that there would be some breakthrough in what I was experiencing.
I think the mythology of psychiatric couches and of the detectives
of the catharsis of hidden trauma has caused people like me a lot
of damage. It was inevitable that with the anxiety and high expectations
that I held for these visits, that there would always be a let down
as I walked home because of course there never was or could be an
Sometimes I think
the doctor who saw me was as confused and as frustrated and bewildered
by me as I was myself. He gave such mixed messages. Sometimes he would
promise me (whilst banging on the table) that life would one day get
better, that one day I would end up living in a rose covered house
with a loving family. At other times he would say the opposite. That
what I was going through was a fundamental part of my character and
that I had to adapt to a life that would always be hard and would
always be unhappy.
Sometimes he would
say that he would not see me any longer if I carried on cutting myself
and then when I did carry on and arrived waiting to be thrown out
of the surgery, he would reverse his decisions and tell me that he
knew all along that I would have carried on in this way.
despite the fact that he was much older, that he didn't really seem
to understand how I could feel or how I felt, and despite my belief
that someone somewhere would one day step in and cure me of the anguish
that my life held, the fact that the doctor was there was a great
help. To know that there was someone who would listen even when I
couldn't speak, who was there to hear and try to understand what I
was going through and who did not look on me as a bad person. This
constancy in my life was something that I held onto like a leaky life-raft
Over time I did
begin to realise that I was not going to kill myself and self-harm
began to become almost a ritual. I would prepare for a session when
I knew I was going to cut myself and also knew that I was not going
to try to kill myself. It was almost something that I had to do and
had to get through.
In later years
the conversations with other people who had done similar things helped
me get a better understanding of what I was doing. It was the most
graphic way of expressing how I felt.
Words were an
entirely incompetent mechanism to talk and give expression to the
slack empty sadness of a life that seemed to stretch onwards in pale
shades and with little relief. Whilst, in contrast, the shocking presence
of blood and later on pain allowed for expression, release and some
way of maintaining a tolerable existence. It was a way of coping with
a life and a pain that I found hard to endure.
In those days
nothing touched me and no one could reach me. I was away, a hundred
miles from the presence of those who might be affected by what I was
doing. Eventually I stopped coping altogether, I gave up.
There were no
other options. It seemed to me that everything was too painful. My
life had become a prison from which I wanted to escape and so one
night I finally took the decision to commit suicide. I took an overdose
of paracetomal and aspirin washed down with whisky over the course
of an evening.
It was so frightening
once I had done it.
Going to bed having
swallowed lots of pills and alcohol was very hard. I was thinking
that this would be the last night that I would experience.
At one point I woke up and was sick. In the morning I woke up very
much alive but not feeling very well at all.
I didn't know
what to do so I made an appointment to see the doctor, which led to
me being admitted to a general hospital and then later on to a psychiatric
hospital. In those days treatment was a lot worse than nowadays. I
was interviewed and asked about my overdose in front of other patients.
I was never told how ill I was. I was shifted from ward to ward and
as a final broken straw, was called by another name after they put
the wrong name on my notes before transferring me to the mental hospital.
I was now at last
in touch with psychiatric services, which was something that my doctor
had been trying to arrange for some time. I also had wanted to see
a psychiatrist but to admit this even to myself was very, very hard.
It signified so much about myself, about maybe being ill when I found
it hard to believe that I was, while at the same time half wishing
that I was. About being dependent, about having control over my destiny
- both having it removed by putting myself in someone else's care
and also reluctantly gaining it by asking for help when I couldn't
bring myself to.
It also meant
that I had acknowledged within myself that I wanted to get better
when I wasn't sure there was anything wrong, or that if there was,
that I wanted to change it. This way, when help from mental health
services stopped being an option, was for me a way of getting assistance
without having to admit to myself that I needed it.
My time in hospital
opened my eyes to life. It was an old hospital in the process of shutting
down. It was shabby and neglected and nothing like I had expected.
My parents found
out that I had been admitted to hospital after a benefit's form was
sent to their house. I will never really understand what they went
through when they found out why I was there. I blamed them for a lot
of my unhappiness and refused to see them. In those days I had no
concerns for their feelings. I had no interest in them at all. Nowadays
I think that it must have been almost unbearable when I think how
much I worry over the life of my son. I just see an echoing wound
of reproach, a terrible, terrible pain that must be so awfully hard
to bear and recover from.
Sometimes I meet
parents whose sons or daughters have attempted suicide and I see the
pain that this has caused. For me my only message is that when I got
to such a state it stopped being possible to see clearly and those
that were around me were only seen through a mist of incomprehension.
The effect that I was having on everyone else was not something that
even came into my world.
I think that that
must have been part of what was going through my friends' minds when,
after celebrating my release from hospital, they surrounded me, pushed
me against a wall and threatened to beat me up if I didn't explain
to them why I could do such a thing. I think that they felt deeply
betrayed and offended and incapable of knowing how they could adapt
to this situation or help me with it.
What got me through
to the other side of this is hard to tell. The fact that I had access
to a good doctor and a very strange and uncommunicative psychiatrist
(who seemed to specialise in silent interviews), probably did help
in that I knew they were there if needed. But for me there were some
fundamental changes in my life that altered how I saw life around
First of all I
do think that time heals. It is a balm even if only because you grow
used to the pain. It can become a companion with which you are familiar
and to which you can adapt and grow used to. I also found something
to do. My experience in hospital had opened my eyes to the things
that people were going through, both to their distress and the injustice
that they were facing.
I became a volunteer
with a mental health organisation whilst still a patient. This transformed
my life. I had something to do. I kept occupied in such a way that
I couldn't dwell too much on myself. I felt as though I was needed
and wanted and useful and that I had something to give and some purpose.
I met people who
had been through similar experiences to mine and found that I was
not as alone as I thought I was. I also began to find a cause in which
I believed and in which I could participate. I met a few people and
made friends with them. Having company, having a meeting of minds,
meeting people with whom I could stay up late at night and solve the
problems of the world, having friends who were not shocked at all
at what I was going through, was really, really great.
The thing that
really took me through to a place of happiness was meeting and marrying
The healing power
of love is probably sneered at nowadays, but to know that someone
cares for you deeply, that they find you attractive and interesting
just as you do them, to run into each others arms, to want to be with
each other as much as possible, does not fit into a world of self
I entered a world
where life was all about living. I will never forget how happy I was
skiing through the forest with my wife, with the blue sky and the
sparkling glitter of crystals of snow, or sailing in the Atlantic
looking at the stars and the dolphins and the flying fish swaying
to the motion of the boat or walking in the mountains, or camping
in a sandstorm in a desert, or looking at the temples in India or
just enjoying making a lovely meal together. I was tremendously lucky
and privileged to do such things and meet such people.
Such things gave
me a life happier and more fulfilling than I could ever have imagined.
People had told me when I was at my lowest and saddest that life would
be better one day and that the unhappiness didn't last forever and
I had found this impossible to believe. I had found their optimism
both laughable, unrealistic and patronising and yet not that many
months later I had left despair a long, long way behind me.
is no fairy tale and we don't live happily every after. In my late
twenties five months after my son was born I became quite dramatically
psychotic and our world turned over and shattered in its expectations.
For a couple of years I was quite often ill and I ended up being diagnosed
as having schizophrenia.
One of the main
things that I went through when I was psychotic was an obsession that
I was evil and that my blood was filled with bad spirits. I felt that
people could read my thoughts and that the spirits that swarmed in
the bright reflections of a summer's day were warping and altering
In the world that
I was living in I thought that the only thing that I could do was
to release my blood and the evil spirits in it in some place of "safe
energy" where they would be neutralised. For
me the woods and the trees with their peace represented a safe place.
Just before I was admitted to hospital, late one evening when my son
was fast asleep in bed, I told my wife about my spirits, the fact
that they were evil and that I was going to go to the woods and cut
The world that
people like me sometimes live in when psychotic can be seen as a horrible
place, a place of fear and confusion and distorted realities, but
when I left her and set off for my woods I think my wife was in a
far more frightening dimension.
To see someone
you love living out a reality that bears no connection with your world
is something that is so hard to adapt to. It is as if all the foundations
on which you have based your life have been shaken and twisted. When
certainty and familiarity have become alien you can lose all your
ideas of what to do or how to act with your loved one. There is nothing
to grasp hold of except that life, in the space of a few days, has
lost the glow of happiness and been replaced with uncertainty and
I didn't hurt
myself very much that evening but I was admitted to the psychiatric
hospital the next day after having a seen a GP. I was completely obsessed
with the spirits that were around me and in me and thought that if
anyone touched me that I would infect them with my badness and corruption.
I thought I had to rid the world of the evil around me either by getting
rid of the blood that was in me or by electrocuting myself. I spent
my time on the ward telling the nurses that I needed to go to the
woods to cut my wrists, but they would not let this happen which I
found incredibly frustrating and hard to understand.
One morning in
the hospital I decided that if I could make certain patterns on my
hands then maybe the spell I wove would stop the progress of the spirits
that was so painful to me. I started burning patterns onto my hands
by stubbing cigarettes out on them. It didn't hurt me very much and
no one noticed what I was doing at first except for one nurse who
I told I had warts when she made a puzzled query at the sight of my
Not long after
lunch on that day I realised that I would not be let away from the
hospital and decided to escape. I left the ward by hiding behind a
lunch trolley and ran to the woods where I climbed a tree in the hospital
Sitting on the
branch of the tree I made a deep cut in my wrist. It was so frightening
and so ugly, and it was at that point where I realised what I was
doing. Psychosis is very strange but it doesn't mean that you lose
all reason. At that point I became very frightened and spent a long
time trying to work out whether to continue to cut myself or to stop.
I chose not to. I threw my razor blade away and walked back to the
ward wondering what on earth I should be doing.
I met one of the
nurses and was taken to the nurse's station where there was a big
kerfuffle. I was still very unhappy about anyone touching me because
I thought they would be damaged by contact with me and yet they had
to stitch my cut and dress my burns. I remember the doctor in particular
being very angry and frustrated at my behaviour.
From that point
I was put on special observations. All the things that I could damage
myself with were taken off of me and a nurse was put within arms reach
of me 24 hours a day. At first I still managed to burn myself occasionally
when I was given cigarettes, but gradually I stopped doing this. Being
"specialled" by the nurses was very, very frustrating. I
felt so trapped, so intruded upon, any pretence of privacy had gone.
I think that it
was very hard on all of us. I was beyond human companionship at the
time and yet at the same time felt incredibly lonely and craved company
and solace. I felt sad and bad and unhappy and although the nurses
tried hard, they were variable in the company they provided. Some
were brilliant. You could feel the warmth of their compassion. Others
were nervous and frustrated which caused tension and others were clearly
just doing a job they had been told to do which only served to increase
the feeling of isolation and loneliness that I had built up around
The first time
I was put off being specialled was amazing; too walk around, to smoke
a cigarette without asking. It was just great. I was still not allowed
off the ward though. I remember the door of the ward became a symbol
of freedom to me. I would walk up and down the corridors passing and
passing the door that I was not allowed out of. The first time I was
allowed through that door without a nurse accompanying me is a particularly
I think that there
are a number of things that strike me from that experience.
First of all that
it was completely different to the other times that I had self harmed.
What I was doing was neither an expression of pain, nor a means of
coping, nor an escape.
For me it was
a logical action to take in the reality that, at that time, had most
bearing on my thoughts. Somewhere in the back of my mind I knew that
I was in a position to do myself a large amount of damage but for
most of the time I thought that by damaging myself I was protecting
the people around me and those that I loved.
I think that the
action that was taken to prevent me hurting myself was very reasonable,
even though it didn't feel so at the time. I feel that hospital, though
a dispiriting lonely place, was an appropriate place of refuge for
the time and much as it pains me, I feel that the large amounts of
medication that I was on both helped me cope with the times that were
unmanageable and also eventually pulled me out of the frightening
world I had come to live in.
What I do wonder
sometimes, though, is whether I would really have harmed myself in
the way I said I wanted to if I had been free to? There was that moment
when I chose not to cut myself any more. Sometimes I wonder whether
hospital with its cocoon of safety and protection allows us the safety
to express ourselves and damage ourselves in ways that would be too
risky in normal society.
To an extent this
is illustrated by the two other times that I became acutely ill. On
both occasions I stayed at home and on both occasions my reality was
alien with the devils and the spirits surrounding me. On both occasions
I would circle my cigarettes above my hands to burn myself and always
I would talk of cutting myself, and always the sight of the pain that
I was causing my wife stopped me doing what I wanted to do.
The tears and
anger of the person I loved kept drawing me back into a reality that
I would not have been able to sustain if I had agreed to go into hospital
where such intensity didn't exist.
Those times at
home were one of the hardest times and hospital a huge temptation.
I think that emotionally we suffered greatly, my wife especially,
but I didn't harm myself and my illness was intense for a matter of
weeks rather than months.
What can I draw
from what I have been saying? I suppose that self-harm and attempted
suicide are very different, and that the self-harm caused when psychotic,
is also very different. But also more generally that many of us cannot
believe we are ill and need and deserve help. It can be very hard
to agree to see people from mental health services, both because there
is a shame in admitting to illness and not coping but also because
services have an image that can discourage contact.
Also the degree
and depth of our sadness can prevent us from seeking out services
when we need then or even in believing that they will be able to help
in the first place.
When we are young
services may seem disconnected from our lives, and that once you have
made contact with services that knowing you have access to professionals
when you need them, is very important even when they do not seem to
The effect of
these actions on those around us can be devastating.
needed, loved and occupied can take you out of the world of self-harm.
appropriate response to self-harm is to see it as a coping mechanism,
whilst at other times we clearly need interventions to stop the damage
that we are doing from happening. Access
to a safe place when distressed is very important. It is important
to be able to make our own sense out of what seems to be such an illogical
and destructive act.
We need to find
our own solutions but this can be a very lonely journey to embark
on and company can be appreciated. Above all, from my point of view
is to be given the possibility to believe that life can get better
- that it is right to dare to hope.
For me now, I
have a superb life. I live in a beautiful place. As I write this I
can look out past the cherry trees and the larch trees to the field
with its rabbits and horse, to the river and forest beyond. I have
a good income, I have a family that I love, and I do work that I love.
I am around people that I respect and this is something many people
do not have and when the struggle to find belief in yourself is made
harder by poverty, poor housing, unemployment and discrimination,
it is easy to see why people may struggle so much.
However for me
nowadays, I find it hard to even contemplate the fact that I could
ever become suicidal again. It seems such an alien thing. There is
so much life to be lived and savoured and appreciated.
I do occasionally
have symptoms of illness. Sometimes I become very unhappy, sometimes
I feel that people can read my thoughts, sometimes I feel that inside
me I remain rotten and corrupt but these are feeling that I am used
to and can manage.
I have no strong
wish any longer to self harm but in the back of my mind razor blades
remain in some perverse way a symbol of safety for the dreaded possibility
of life becoming unmanageable again. I have talked about my experience
of self harming and attempting suicide. However in my job and the
work of many of you too, self harm and suicide is a routine part of
I have lost count
of the number of people that I know who have felt suicidal or who
have self harmed. It is strange that such a desperate thing can become
a routine in our lives. We are, I hope, slowly coming out of the dark
ages of the treatment of such people. However we all know that in
the recent past at least, people have been routinely been made to
feel worthless in Accident & Emergency departments and hospital
People have vivid
memories of being regarded as time wasters, attention seekers, manipulators
- of being less important than people with more conventional illnesses
or injuries, of being wicked or evil or immoral. People have talked
of the contempt in which they have been held. People have talked of
being ignored and sneered at, and been told that there are people
in genuine need of hospital beds unlike them. People
have had doctors refuse to come to see them after they have badly
injured themselves, to the extent that the police have had to be called
out to insist that they will come and help the person with their problem.
This is all very
wrong. The one thing that people need when so desperate and so unhappy
is understanding and human warmth and a lack of judgment that continues
to last as long as the person remains in such a lonely world.
Many people who
self harm are diagnosed as having personality disorders. A wonderful
diagnosis with which to shunt all those problem people, all those
awkward people, all those people you heave a sigh of frustration at.
A diagnosis, that because it is neither an illness nor regarded as
treatable, allows those that wish to wipe their hands and consciences
clear by refusing assistance and leaving them to get on with the agony
of sometimes unlivable lives.
We need desperately
to find out what it is that causes people to end up in these states.
We need to be confident that one day we will find ways of helping
such people on to better lives. We need to know that such people have
a right to treatment, to help and to hope.
We need through
speaking out and through training to reduce the stigma of such actions.
We need to know that in the near future, people will never be put
off having treatment because of their shame or the way in which professionals
It is hard though
and I have often had people phone me, some of whom are in the act
of self harming or attempting suicide. Sometimes after the initial
panic and the busy sorting out of access to routes for help, you can
settle down in the tension of the aftermath and know that there is
nothing that you can do, and that the solace you offer is only a temporary
balm that will fade as quickly as it is applied. There are sometimes
no solutions, no miracles and sometimes after you have heard time
and time again from the same person your heart can harden into a professional
veneer for your own safety and that can be hard to cope with too.
There are no easy
procedures either. Sometimes the crisis is so clear and direct and
urgent that you know that you need to get someone in to help. Sometimes
the person knows what they want from you and if you can, you supply
it, but often you can only listen, only hear the pain, only know that
there is nothing to be done and no services able to respond and that
can be so depressing and hard to cope with.
I will finish
by talking about those around me who have not come through to the
There is Graham
who died in the Grand Canyon.
There is Michael who jumped off the Forth Road Bridge.
There is Ken who stood in front of the London train.
There is a friend who wouldn't want to be named who swallowed cleaning
There is Quentin who was found floating in the sea.
There is Pete who took an overdose.
I feel a huge
sense of loss that such precious people that I have known are no longer
with us and dedicate this talk to them. You will all have knowledge
of other people who have died in this way. For me I have a crude way
of dealing with this in my mind. When people are living, I choose
to think that the main task is to keep them living and to prevent
suicide, but for those that have died I choose to hope that they have
found a form of peace, maybe sanctuary from unbearable lives. I hope
that is what they have found anyway.
I suppose the
only message that I would leave you with is that of respect. It is
central to so much of what we are all doing. The people who enter
worlds and harm themselves in such distressing ways are also entitled
to respect. What is wrong with seeking attention when your world is
in ribbons? What is wrong with trying to get the help you need when
no one listens? We are all manipulative to an extent. We who do such
things to ourselves suffer enough and to label our actions as a wicked
or evil does not help at all.
Trying to understand
each other, being there for each other, looking after ourselves, becoming
comfortable with our emotions and seeking help when we suffer are
such simple but such dramatically helpful things.